The recovery response to a novel unannounced laboratory-induced slip: The "first trial effect" in older adults.

BACKGROUND After a single slip, older adults rapidly make adaptive changes to avoid or eliminate further backward loss of balance or a fall. This rapid adaptation has been termed the "single trial effect". The purpose of this study was to explore the relationship between the motor errors subjects experienced upon a novel slip and the selection and execution of corrective response by which they modified their ongoing gait pattern and turned it into a protective step. METHODS A forward slip was induced in the laboratory among 145 community-living older (≥65year old) adults who were protected by an overhead full body harness system. An eight-camera motion analysis system recorded subjects' kinematics, which was used to compute their instability (motor error), recovery step placement (response selection), and stability gain (motor correction). FINDINGS A linear relationship was found between the stability errors at recovery foot liftoff and the distance between the recovery foot and slipping foot at the time of its touchdown, reflecting an appropriate selection of response that was proportionate to the motor error. A linear relationship was also found between this step modification and resulting stability gain, indicating that greater step modification resulted in greater stability gain. This learning behavior was surprisingly consistent regardless whether the outcome was a recovery or a fall. INTERPRETATIONS These results suggest that fallers and non-fallers all have an intact motor learning foundation that has enabled them to rapidly improve their stability in subsequent exposures.